Prospective Coaching Questionnaire
Please answer the questions below as honestly as possible. Your responses will help to identify the best fit for your current needs, either with our coaching services (New Day PSC) or with a referral to another provider who can more effectively suit your needs.
Enter your first and last name *
Your answer
Enter your most reliable email address *
Your answer
Enter your preferred phone number *
Your answer
How did you find out about the coaching services offered by New Day PSC/Dr. Medley (i.e., what or who was your referral source)? *
Your answer
Have you participated in coaching services in the past? *
What types of services are you currently interested in? (more than 1 box can be checked) *
Required
In one sentence, what is the main area where you want to see growth/change? *
Your answer
What will be the impact on your life when you're able to see growth/change in this area? *
Your answer
How soon would you like to have your first coaching session? *
Your answer
What is your general availability for attending coaching sessions? What days and times are most convenient for you to set aside for regular sessions? *
Your answer
You will be contacted within 2 business days after the receipt of your responses. If you have questions or concerns prior to being contacted, you may reach us at (972) 454-9304 or NewDayLifeSkills@gmail.com Please enter today's date. *
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Thank you for your responses.
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